On Monday 19 June 2006 12:26, Cedric Meyerowitz wrote: > I have attended various conferences given by top Cardiologists from Sydney > & Melbourne over the last 10 years. Every single one has always challenged > the NPS on that.
Ah, "evidence by big name". Do you really believe in that? That said, most discussions I witnessed with eminent cardiologists were rather about whether ACEIs should be *included* as first choice medications (to which I agree) than whether lwo does Thiazides or beta blockers should be *excluded* from the list of first choices. > Every single one of them has only had thei patients > wellbeing at heart. At some of these conferences / Seminars I was at, > there were at times other Cardiologists in the audience, and they would've > objected if the material presented was wrong. Doubtless they have their patient's best interest at heart, but they are "speicalists". They see their own goals (reduced number of CV events) as sole goal. I, as a GP, see reduced overall mortality and morbidity as the sole goal, and - with the public and preventive health focus of GP - the sustainability of the health system. > NPS now however (I was at > a seminar given by the NPS last Wednesday where I asked this question) > publishes in their new guidelines that Thiazides / Betablockers not 1st > choice anymore. I have never let a drugrep teach me Medicine. http://www.nps.org.au/site.php?content=%2Fresources%2Fcontent%2Ftopics.php&task=view&type=Hypertension I could not find any change in the guidelines, maybe you can point me out to a specific reference? I also attended such NPS seminar several weeks ago in Brisbane, and it was not my impression that they stated that "Thiazides / Betablockers not 1st choice anymore", but rather that ACEIs should be considered as well, depending on the case at hand. Maybe one of us understood it wrong, or maybe both of us? > More important. Nobody to date has shown me papers on studies with > Thiazides that they work for 24 hours and provide 24 hour BP control. If > you have any, I'd appreciate if you send them to me. (We all badmouth the > older ACEs because they are not true once a day medication). And why should it matter? Nobody has demonstrated so far that true rigid 24 hr BP control is associated with reduced overall mortality or reduced morbidity - the only two outcomes that really count for me. If it doesn't make me live both longer and better, why bother? > Further the government does value the input from the NPS And there is nothing wrong with that, even if it is a bit of a surprise that the current government would listen to any sensible advice. Horst _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
